Pediatric Spontaneous Pneumothorax

Dotson, Kurtis; Johnson, Laurie H.

doi:10.1097/pec.0b013e31825d2dd5

Cited by 64 publications

(56 citation statements)

References 73 publications

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“…Most of what is currently known about the radiological presentation of pneumothorax in the neonatal population has been extrapolated from adult data or small pediatric case series [7,8,9,11,12,13,16,17,18]. It was shown in the previous literature that the time between the onset of pneumothorax and a definitive clinical diagnosis ranged between 1 and 10 h in the pediatric population [19].…”

Section: Discussionmentioning

confidence: 99%

The Utility of Special Radiological Signs on Routinely Obtained Supine Anteroposterior Chest Radiographs for the Early Recognition of Neonatal Pneumothorax

Cizmeci

Akın²,

Kanburoğlu

et al. 2013

Neonatology

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Background: Bedside chest radiographs used for the confirmation of diagnosis of pneumothorax in the neonatal intensive care unit (NICU) are routinely obtained in the supine position. However, pneumothoraces may not appear in the classically described forms on these radiographs, resulting in a delayed diagnosis. Objective: To assess the utility of special radiological signs in the neonatal population for the early recognition of pneumothorax. Methods: A case-control study was conducted at a level III referral center from January 2006 to December 2012. For each neonate with pneumothorax, one infant was selected for the control group. A senior radiologist and neonatologist experienced in reading chest radiographs evaluated each radiograph for the presence of special radiological signs. Results: Of the 1,375 infants admitted to the NICU during the study period, 39 had a pneumothorax. A total of 223 radiographs were scored and 46% of the neonates were found to have occult pneumothoraces before they were clinically diagnosed. Twenty-six percent had a single sign detected on a radiograph, whereas 20% had multiple signs. The time interval between the appearance of these signs and clinical diagnosis ranged between 0.5 and 27 h. Conclusions: The present study shows that the recognition of these signs would assist the physician in identifying occult pneumothorax earlier in its course. Physicians dealing with critically ill infants should ensure that they can recognize these radiological signs.

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Section: Discussionmentioning

confidence: 99%

The Utility of Special Radiological Signs on Routinely Obtained Supine Anteroposterior Chest Radiographs for the Early Recognition of Neonatal Pneumothorax

Cizmeci

Akın²,

Kanburoğlu

et al. 2013

Neonatology

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“…28,30 Pneumothorax Spontaneous pneumothoraces are estimated to occur in 4 per 100,000 male and 1.1 per 100,000 female children. 31 Primary pneumothoraces have no specific, identifiable underlying etiology, although blebs and bullae are frequently identified on imaging or at surgery. Secondary pneumothoraces are due to diseases such as asthma, cystic fibrosis, or connective tissue disorders.…”

Section: Middle Lobe Syndromementioning

confidence: 99%

Surgical management for complications of pediatric lung injury

Pandian

Hamner

2015

Seminars in Pediatric Surgery

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“…15 linfomas, metástasis, deficiencia de α 1 antitripsina, síndrome de Marfan, síndrome de Ehlers-Danlos y artritis idiopática juvenil, entre otras. 12 E l c o m p r o m i s o p u l m o n a r e n l a H C L multisistémica es aproximadamente del 20 al 40% de los casos, y la afectación pulmonar observada en niños es parte de esta enfermedad generalizada. En contraste, la HCL pulmonar se observa principalmente en adultos jóvenes y no en niños, sobre todo por su estrecha relación con el tabaquismo, que condiciona una a.…”

Section: Figura 2 Tomografía Computada De Tórax Imágenes De Aspectounclassified

“…La tomografía computada de pulmón es una herramienta esencial para establecer e l d i a g n ó s t i c o d e H C L p u l m o n a r , y l o s principales hallazgos incluyen nódulos y quistes primariamente en lóbulos superiores, pero el diagnóstico definitivo requiere la demostración histológica de lesiones típicas, que contienen células de Langerhans en el tejido pulmonar, la presencia de gránulos de Birbeck por microscopia electrónica y de anticuerpos CD1a y S100 por inmunohistoquímica. [10][11][12] descripción del caso Niño de 2 años de edad, previamente sano, que presenta, con una semana de evolución, fiebre, hiporexia, rinorrea, tos y dificultad respiratoria progresiva.…”

Section: Introductionunclassified

Neumotórax bilateral espontáneo como forma de presentación de histiocitosis de células de Langerhans

2014

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ResumenLa histiocitosis de células de Langerhans pulmonar es una patología intersticial en la que existe un acúmulo de células histiocíticas específicas a nivel pulmonar. El neumotórax espontáneo es una complicación reconocida de histiocitosis de células de Langerhans pulmonar y es secundario a la destrucción del parénquima pulmonar con cambios quísticos asociados. Reportamos el caso de un niño de 2 años con neumotórax espontáneo bilateral recurrente, con una tomografía axial computada de tórax con infiltrado intersticial, fibrosis, lesiones quísticas e imágenes bullosas. El diagnóstico fue establecido por examen histológico e inmunohistoquímica de tejido de biopsia pulmonar con anticuerpos CD1 y S100 positivos. El niño recibió tratamiento con prednisona y etopósido, con buena respuesta clínica y tomográfica. Palabras clave: neumotórax espontáneo, histiocitosis de células de Langerhans pulmonar. ABsTRACTPulmonary Langerhans cell histiocytosis is an interstitial lung disease that results from the accumulation of specific histiocytic cells in the lung. Spontaneous pneumothorax is a recognized feature of pulmonary Langerhans cell histiocytosis and results from destruction of lung parenchyma with associated cystic changes. We report on a 2-year-old boy with recurrent bilateral spontaneous pneumothorax; a computed tomography scan showed marked interstitial changes, fibrosis, cystic spaces and bilateral bullae. The diagnosis was confirmed by the histology and the immunohistochemistry examination of the pulmonary biopsy with CD1 and S100 positive antibodies. The child was treated with prednisone and etoposide, and had a good clinical response and favorable changes in the second thoracic CT scan. Bilateral spontaneous pneumothorax as a setting of Langerhans cell histiocytosis InTRoduCCIónLa histiocitosis de células de Langerhans (HCL) comprende un grupo de enfermedades con diferente curso clínico. Previamente, se incluían en este grupo el granuloma eosinofílico, la enfermedad de Hand-Schüller-Christian y la enfermedad de Letterer-Siwe. Luego, se agruparon como histiocitosis X, que, en 1987, fue clasificada como histiocitosis de células de Langerhans. 1-2La HCL tiene una presentación variable: puede afectar a un solo órgano, como hueso, piel, nódulos linfáticos, pulmón y glándula pituitaria, o ser de afectación multisistémica, que incluye el sistema hematopoyético, hígado, bazo y pulmones, y que tiene una mortalidad significativamente alta. 3-4La afectación pulmonar por HCL es muy rara en niños; contrariamente, en adultos, se reporta entre un 90 y un 100% de asociación entre HCL pulmonar y antecedentes de tabaquismo. 5-6Se desconoce la prevalencia de HCL pulmonar. Informes de una serie de biopsias pulmonares en pacientes adultos con patología pulmonar intersticial reportan una frecuencia del 5% de HCL pulmonar.7 En una serie de 1382 pacientes adultos con patología pulmonar difusa, en 91 (6,6%), se estableció el diagnóstico de HCL pulmonar. 8Los pacientes con HCL pulmonar presentan síntomas respiratorios inespecíficos, c...

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Pediatric Spontaneous Pneumothorax

Cited by 64 publications

References 73 publications

The Utility of Special Radiological Signs on Routinely Obtained Supine Anteroposterior Chest Radiographs for the Early Recognition of Neonatal Pneumothorax

The Utility of Special Radiological Signs on Routinely Obtained Supine Anteroposterior Chest Radiographs for the Early Recognition of Neonatal Pneumothorax

Surgical management for complications of pediatric lung injury

Neumotórax bilateral espontáneo como forma de presentación de histiocitosis de células de Langerhans

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